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Objective@#To explore growth and intelligence development of low birth weight infants (LBWI) at 24 and 36 months of age, so as to provide reference for early monitoring and intervention of the development of LBWI.@*Methods@#A total of 100 LBWI born and managed in Hefei Maternal and Child Health Care Institution were selected from 2012 October 1 to 2015 December 30, and 99 normal birth weight infants (NBWI) under child health management in the same sitinstitution were selected as controls. According a prospective cohort study method, and based on the establishment of a cohort and monitoring of childhood growth and development, a unified method was used to longitudinally follow up and observe the physical fitness of two groups of infants at the determined time points. The development of LBWI and NBWI at 24 and 36 months of age was surveyed using the Gesell Development Scale.@*Results@#Weight, length and head circumference of LBWI children at the age of 15-36 months were significantly lower than those of NBWI children ( P <0.05). In addition, 117 children (43.98%) completed the full assessment of intelligent development scale, including 62 LBWI and 55 NBWI. The scores of Gesell in NBWI group was higher than that in LBWI group at 24 and 36 months of age, including adaptability, gross motor, fine metor skills, language and personal social functions ( t =-4.17, -3.82, -3.21 , -3.03, -2.61; -4.23, -3.16, -3.07, -3.13, -3.99, P <0.05). Multivariate linear regression analysis found that birth weight was positively correlated with adaptability, gross motor, fine motor skills, language functions at 24 and 36 months of age and personal social function at 36 months of age ( β =0.004, 0.010; 0.003, 0.008; 0.003, 0.007; 0.004, 0.009; 0.011, P ＜0.05).@*Conclusion@#The growth and development of LBWI children are significantly delayed compared to NBWI children. The scores of LBWI children are lower than those of NBWI children in all functional areas. Weight is the main factor affecting children s intellectual development. Early monitoring and intervention of low birth weight infants should be carried out to avoid or mitigate adverse consequences.
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Objective: To establish a prediction model for the distant metastasis of breast cancer based on qualitative magnetic reso-nance imaging (MRI) parameters. Methods: A retrospective analysis of 3,032 patients with breast MRI from January 2011 to Decem-ber 2016 in Tianjin Medical University Cancer Institute and Hospital was conducted. After the confirmation of invasive breast cancer, the subjects were divided in 2 groups: metastasis and metastasis-free. A total of 93 patients were included in the metastasis group, and 186 patients without the presence of distant metastasis in the metastasis-free group. We analyzed the correlation between breast cancer molecular subtypes and distant metastasis in the metastasis group. Univariate and Logistic regression analyses of qualitative MRI features were performed for the groups. Subsequently, we used the results to establish prediction models. Results: The results showed that hormone receptor-positive tumors (Luminal type) had a greater tendency to develop bone metastasis in the metastasis group. Triple-negative tumors showed a greater tendency to develop lung metastasis. Human epidermal growth factor receptor 2 gene overexpression cases were more likely to develop liver metastasis. The results of the univariate analysis showed that the type of le-sion, multifocality or multicentricity of the cancer, T1-weighted signal uniformity, T2-weighted signal uniformity, and tumor size were statistically different between the groups (P<0.05). The results of the logistic regression analysis showed that the type of lesion, multi-focality or multicentricity of the cancer, T2-weighted signal uniformity, and tumor size were independent predictors of distant metasta-sis. Based on select independent predictors, we established a prediction model for the distant visceral metastasis of breast cancer. The accuracy, area under the curve, sensitivity, and specificity of the model were 82.8%, 0.801, 85.7%, and 75.0%, respectively. Conclu-sions: The prediction model based on the clinical pathology and MRI features established in this study can predict the distant metasta-sis of breast cancer.
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Objective: To investigate the correlations between parameters of histograms of the apparent diffusion coefficient (ADC) with multi-b-value diffusion-weighted imaging (DWI) at 3.0T MRI and prognostic factors and molecular subtypes of breast cancer, to evaluate the diagnostic performance of ADC histograms at different b values. Methods: A total of 114 patients (116 lesions) with inva-sive ductal carcinomas confirmed by surgical pathology who underwent breast magnetic resonance imaging from March 2015 to Janu-ary 2016 in Tianjin Medical University Cancer Institute and Hospital were analyzed retrospectively. The histograms of ADC with b val-ues of 0, 500, 800, 1000, and 1,500 s/mm2 were generated using Image J software. Various parameters were calculated: for example, the minimum, mean, mode, skewness, and kurtosis. Different groups were based on the molecular subtypes, tumor size (T1 vs . T2-3), histologic grade (high vs. low), and lymph node status (positive vs. negative) that were recorded. Mann-Whitney U tests were used to compare the differences in ADC histogram parameters between two different groups. Receiver operating characteristic curves (ROC) were constructed. Results: The skewness was lower in Luminal tumors than that in non-Luminal tumors with b values of 500, 800, 1, 000, and 1,500s/mm2 (P<0.05). The ADCmin was higher in human epidermal growth factor receptor-2 (HER-2) over-expression than in non-HER-2 over-expression (P<0.05). The kurtosis was lower in stage T1 tumors than stage T2-3 tumors (P<0.05), and kurtosis was cor-related with tumor size (P<0.05). ADCmode and ADCmean were different between different histological subtypes with a b value of 500 s/mm2 (P<0.05). Under different b values, there were no significant differences in terms of areas under the curve for each histogram pa-rameter, which had statistically significant differences (P>0.05). Conclusions: Multi-b-value DWI ADC histogram analysis, as a quantita- tive method to characterize tumor heterogeneity, can reflect the biological behavior and prognosis of breast cancer to some extent, and the diagnostic performance of ADC histograms showed no significant differences in differentiating molecular types and prognostic factors of breast cancer at different b values.
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Objective To investigate the magnetic resonance imaging (MRI) features and differential diagnosis of axillary schwannomas, and analyze the causes of misdiagnosis. Methods A retrospective study from October 2014 to October 2017 was performed in 5 patients with axillary schwannomas, confirmed by surgery and pathology, in whom clinically suspected axillary metastases have been diagnosed. All the patients underwent breast MRI to summarize the key points of diagnosis and differential diagnosis. Results Five tumors located in neurovascular bundles extending along the brachial plexus nerve distribution. The tumors presented as single, spindle or ovoid masses, well-circumscribed margins in 4 cases, entering and exiting nerve signs in 5 cases, the split fat sign in 4 cases, vascular compressed sign in 5 cases, and target sign in 1 case. The tumors were isointense or slight hypointense on T1WI compared to the adjacent muscle. Three tumors manifested heterogeneous slight hyperintense, 1 tumor was slight hyperintense, and the target sign was seen in 1 tumor on T2WI. Diffusion-weighted image was heterogeneous hyper or slightly hyper-intense. When b＝500 and 1 000 s/mm2, the apparent diffusion coefficient (ADC) was (1.40 - 2.23) × 10 -3mm2/s and (1.31 -2.94) × 10-3mm2/s respectively. All the 5 tumors manifested persistent enhancement on dynamic contrast-enhanced MRI (DCE-MRI). Three tumors were heterogeneously enhanced, and 2 tumors were circularly enhanced. Conclusions Axillary schwannomas has certain characteristics which can be helpful for the identification of metastatic lymph nodes.
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Objective To investigate two-dimensional color Doppler commissure real-time shear wave elastrography (SWE) examination and its application value in the diagnosis of breast diseases.Methods One hundred and thirty patients (158 breast lesions) confirmed with breast disease were chosen from September 2013 to September 2014,and all patients underwent two-dimensional color Doppler ultrasound and SWE examination.The receiver operating characteristic (ROC) curve was examined to obtain maximum elasticity modulus value,average elastic modulus value and the corresponding critical value for the diagnosis of benign and malignant breast lesions.According to the results of pathological examination,sensitivity,specificity and accuracy of two-dimensional ultrasound and SWE for the diagnosis of breast lesions were evaluated and compared.Results Of all 158 breast lesions in 130 patients,90 were malignant lesions and 68 were benign lesions.The sensitivities of two-dimensional ultrasound and SWE in diagnosis of breast cancer were 89.7％ and 89.5％,the specificities were 85.6％ and 95.3％ and the accuracy were 87.3％ and 91.4％,respectively.The sensitivity,specificity and accuracy in the diagnosis of breast cancer by combination of two-dimensional ultrasound and SWE were 98.5％,93.3％,95.6％,respectively.Conclusions Although two-dimensional color Doppler ultrasound is a commonly used method in the diagnosis of breast lesions,it has certain limitation.The specificity of diagnosis can be improved by SWE,which is a useful complement to traditional two-dimensional ultrasound technology.Combination of the two methods can significantly increase the sensitivity and accuracy of the diagnosis and provide a reliable basis for the differential diagnosis,reduce the rate of misdiagnosis,missed diagnosis and unnecessary biopsy,which has important clinical application value.
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Objective To explore students nurses′acceptance of case-based group assessment. Method A total of 100 student nurses participated in the survey by a self-designed questionnaire to evaluate the perception and acceptance of the student nurses. Results The score on the acceptance of case-based group assessment was (2.44 ± 0.46). The items with higher acceptance included teamwork spirit, clinical reasoning and decision-making ability, and the items with lower acceptance were improving of nurse-patient communication and the nursing skills. Conclusions The student nurses have a good acceptance of the case-based group assessment and think this assessment method can contribute to development of teamwork spirit and competency of clinical reasoning and decision-making. On the other hand, they suggest we should strengthen the ability in nurse-patient communication and optimize the links in ability assessment.
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Objective To systematically review the clinical effectiveness of Chinese medicine in treating nasopharyngeal carcinoma patients with radioactive xerostomia. Methods The randomized or semi-randomized controlled trials of the Chinese medicine for nasopharyngeal carcinoam patients with radioactive xerostomia were screened out by online retrieving and manual retrieving of domestic and oversea databases such as Cochrane Library, JBI Library, PubMed, OVID, EMBase, Web of Science, CNKI, Wanfang Database, VIP Database, CBM Database. The data extract and quality assessment were performed by two reviewers independently. Meta-analysis was conducted for the included trials. Results Eight trials were included. The results of Meta-analysis showed that Chinese medicine can effectively delay the progress of oral mucous membrane ulcer in nasopharyngeal carcinoma patients after radiotherapy, and decrease the incidence of grade 3-4 oral mucous membrane ulcer ( Z=4.86, P<0.00001) . Conclusion Chinese medicine has certain effect in treating nasopharyngeal carcinoma patients with radioactive xerostomia.
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Objective To assess the enhancement characteristic of breast lesions of contrast-enhanced ultrasound (CEUS) in comparison with contrast-enhanced magnetic resonance imaging (MRI).Methods Between August 2011 and March 2013,72 women with 72 lesions were enrolled.All patients underwent ultrasound,CEUS and MRI.The histopathologic results obtained from ultrasound-guided core biopsy or operation excisions were used as the reference standard.CEUS section evaluations were made similar with MRI regarding the size and shape of lesions.Different contrast enhancement patterns including homogeneous/heterogeneous,the tumor areas,the perfusion defect areas,and modality of time-intensity curve were evaluated.Pearson's correlation coefficient,Student's t-tests,and the concordance test were used for evaluation.Results Of the 72 lesions,pathologic examination revealed 56 (77.8％) malignant lesions and 16 (22.2％) benign lesions.The tumor areas measured by CEUS and MRI agreed well,with a correlation of r =0.894,P =0.000.The difference between the two measurements was not significant according to a paired t test (P =0.886).The concordance tests gave a value of the coefficient Kappa =-0.153 (P =0.061),indicating a low concordance between the results obtained with CEUS and those obtained with MRI regarding the enhanced uniformity.There were statistically significant differences in the perfusion defect areas as measured by CEUS and MRI (P =0.01).The CEUS estimates [(0.837 ± 0.827)cm2] were consistently higher than the MRI estimates [(0.576 ± 0.524)cm2].The time-intensity curve patterns between the two groups showed no correlation.Conclusions The enhancement patterns evaluated by CEUS and MRI partly agreed well.There was no direct association between the two methods regarding the enhancement patterns because of the different contrast agent.
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Objective:This study aims to evaluate the sonographic features of phyllodes tumors of the breast (PTBs) and the cor-relation between sonographic and pathologic findings to improve the understanding of the disease. Methods:Sonographic findings of 85 PTBs from 83 patients were reviewed. The sonographic findings included the results of two-dimensional ultrasound and color Dop-pler flow imaging, elastographic features, and pathologic data. Results:Of the 85 lesions, 33 were the benign tumors, 28 were border-line, and 24 were malignant according to the pathologic diagnosis. Tumor morphology revealed that most masses were lobulated, with a clear-cut boundary, smooth verge, and inhomogeneous internal echo. Clear boundary was more common in the benign phyllodes tumors (χ2=12.721, P=0.002), and a cystic echo-free area was more commonly observed in these malignant tumors (χ2=9.677, P=0.046). LevelⅡandⅢsignals of the blood flow were observed in 75.3%of PTB cases. Of all lesions, only 26 were subjected to elasticity imaging, and the elastographic scores ranged from 2 to 3 in 88.5%of the cases (23/26). Conclusion:Conventional ultrasound and elastographic findings on PTBs exhibited definite characteristics. The border and cystic areas in the tumors can be used to differentiate between be-nign and malignant PTBs.